Abstract
Malaria is the leading cause of morbidity and mortality and accounted for 40% and 30% of the outpatient attendance in 2011 in Migori and Kwale counties respectively. Perhaps, one reason for this high morbidity is the lack of capacity to deliver malaria interventions. CHVs are individuals chosen by the community and trained to address health issues of individuals, households and communities. They are catalysts, whose role is to enable individuals take control of their health. A community based comparative analytical intervention study design was implemented at baseline and four years Post-intervention to measure the impact. Migori and Kwale counties were compared before and after intervention. Kwale County served as control. A baseline and follow-up Household Surveys in each of the counties were conducted to act as the pre-data and post-data respectively. In general malaria cases reduced significantly in Migori z=3.0645; 95% CI between baseline and endline surveys compared to Kwale z=-0.8431; 95%CI. Testing for malaria in 2013 and 2016 in Migori increased significantly z=+27.35; 95%CI compared to Kwale, z=+4.799; 95%CI. Those who took ACTs within 24hrs of onset of fever increased significantly in Migori z=5.54; 95%CI compared to Kwale z=1.30; 95%CI. Nets in use the night before survey by children <5 years increased significantly in Migori z=+22.36; 95%CI compared to Kwale z=+1.04; 95%CI. Nets in use the night before survey by pregnant women increased significantly in Migori z=+4.41; 95%CI compared to Kwale z=+0.679; 95%CI. The study concludes that involving and engaging trained CHVs contributes significantly to malaria morbidity reduction.
Key words: Malaria Morbidity, Strengthened Community Health Services, Baseline, Endline, Households.